Social services agencies in Shawnee County will have to look elsewhere for funding. The Shawnee County Commission decided on a 2-to-1 vote to cut funds in 2014 from social services agencies and elderly programs.

Positive Connections lost all $30,000 of its county funding that goes toward HIV treatment and prevention. The dollar amount translates into about 22 people not being able to receive case management to treat their HIV and also about 100 people not being able to receive free HIV testing.

"This is a devastating cut for our agency," Executive Director Debbie Guilbault said. "We will do the best that we can to continue providing the services we do. We will make sure our clients are first and foremost."

Guilbault spoke to the commissioners in the Thursday morning meeting, asking them to reconsider the cuts.

The $30,000 the agency received in 2013 was divided up for case management services and prevention services. Case management received $21,800 and Guilbault said it covered a full range of services such as getting clients enrolled in the Ryan White program, which connects HIV-positive people to treatment. Case management is required to be eligible for Ryan White assistance.

It also gets people connected to subsidized housing and food pantry organizations. Guilbault said many times it's hard for HIV-positive people to pay the rent or buy basic necessities because they have to buy expensive HIV medications. Guilbault said if they're not worrying about how they're going to pay rent or buy food, they'll likely adhere to their medication regimen.

The rest of the money goes toward HIV testing, which Guilbault says is essential for early detection and keeping the community as a whole healthy.

While she agrees with Commissioner Bob Archer that there are other places in the county to get tested for HIV, she says Positive Connections does the tests for free, and establishes a relationship with those they serve.

"There's a piece of risk reduction, information, counseling, education that's done with our test that may not be done at other places."

Guilbault says she does not know immediately how it will affect the agency, and that her board must decide what services to cut. They've had to deal with cuts in the past, and she doesn't know what more they can do without.

"We really have cut to the bare bones. We don't do anything extra. Our staff has not had increases in the past 4-5 years and they're very hard-working and passionate."

Positive Connections has two case managers, each with a case load of about 75 to 80 people.

A total of $100,000 dollars to social services was cut. Programs that serve the elderly took an $80,000 hit. The LULAC Senior Center's transportation service is losing $5,000. It shuttles Topeka's elderly and disabled to their medical appointments.

"We wont' have money for gasoline, maintenance on vehicles, things like that," LULAC Board Chair Robert Soria said. "We have to really be careful about how many rides we're giving, so we can only do so much."

LULAC was one of the agencies who received a lesser amount of cuts, but Soria says it is still a set-back.

"We're grateful we're still getting a good amount of funding from the county but at the same time it's still a cut, and we're going to have to cover that cost.

Soria said they'll never turn people down for rides,but will have to make-do with the $50,000 they will receive, versus the $55,00 they asked for.

"It helps our elderly to live longer and be there longer with us."

The final vote was divided and commissioners seemed reluctant to adopt the resolution.

Many people in the county may be left without a place to get their children's teeth cleaned, or go for a check-up, or a place to get HIV treatment.

The services that so many depend on may not be available if the Shawnee County commission cuts funding Thursday.

Leaders from those organizations facing the chopping block will ask the commission to not just consider the dollars, but how it translates into actual human lives.

The Marian Clinic is one of the organizations facing cuts. They usually receive about $30,000 from the county. A $12,000 cut to its dental program will make it harder to serve Topeka's uninsured and poverty-stricken.

"That's about 104 patients in through the door where we'll have to cover that cost in another way," CEO of Marian Clinic Karily Taylor said.

Last year doctors who volunteered their time to the clinic saw 8,500 patients, many unable to pay anything.

Marian runs entirely on charitable donations and help. Patients see doctors and dentists from local offices who are volunteering their time. The clinic does ask its patients to provide a "contribution," basically a co-pay, of $15. Taylor said many of the patients cannot afford that. Marian is not set up for billing or coding, so they do not make any revenue.

"I don't foresee we'll have to turn patients away. The more likely impact for us is the ability to provide additional resources," Taylor said, "being able to send home a family with toothbrushes and toothpaste. That sounds silly but we spend about $20,000 a year on toothpaste and toothbrushes."

Taylor said the clinic is all-encompassing, being the primary care provider for its patients. She stressed the importance of giving cleanings and screenings and also extending resources for families to take home.

"There's been such a drastic cut to social service funding and there's such an incredible need in this town. I think this is probably just a drop in the bucket."

Taylor said employee benefits are taken care of through the Sisters of Charity Health System, but the clinic will have to partner with organizations to make up for the $12,000 cut. She said they have relied heavily on outside donors and the faith community to keep the doors open.

While Taylor and others at Marian have to face difficult decisions, she said she's grateful for the funding they've received so far. The cuts do, however, reach beyond Marian.

"We understand that we're not the only agency that's been cut."

Marian Clinic is not alone. While they're facing less cuts from the county, Positive Connections - which provides HIV prevention services and programs to keep those infected with the virus healthy and alive - could lose its entire $30,000 dollars in county funding. Positive Connections runs on a $300,000 budget. The cut is 10% of that.

"We're looking at a translation of 22 people not being able to get services, and these are life-saving services," Executive Director Debbie Guilbault said. "I don't know how to cut 22 people off and say sorry, we can't serve you."

Five years ago Positive Connections had a case load of 113 people needing HIV treatment services. At the end of this September the number was up to 148, and 6-8 new clients have since been added to the list. Those people are helped by two case managers. The budget for case management five years ago was $160,000. This year it is $145,000, and after the possible new cuts factored in, the budget would sit at $120,000.

The case management program would lose $21,000. It takes $1,000 per year to keep people in that management. That's where the 22 people would lose services. That means getting people care and on medication to eventually reach viral suppression.

"These are services that if they don't have, their HIV gets out-of-control. If they don't have access to meds they can die."

Free HIV testing is also a big part of Positive Connections. The cuts would take away almost $9,000, meaning 100 people wouldn't be able to get tested.

Guibault said they've already had to absorb cuts in the past couple years, and this additional cut could wipe out some services completely, or force them to put people on a waiting list.

"We've never had to create a waiting list, we have not had to cut any services. We've just done it better and smarter and more efficiently. How do you create a waiting list? How do you decide who goes on that and how do you create a waiting list on something that's life-saving?"

Guibault said they'll have to look into fundraising and applying for additional grants. She said cutting employees is out of the question because they are so under-staffed anyway.

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